Kelley Susan Wiese, MSW

Primary specialty

Clinical Social WorkerTaxonomy code 1041C0700X

License

6801103963 Issued in MI

Practice address

612 Corvus Dr
Midland, MI 48642-8111

Phone

(614) 805-2930

NPI assigned

Jun 17, 2019

Sex

Female

Sole proprietor

Yes

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in MI

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: No
• Power mobility devices: No
• Hospice: No

Green means eligible to order or refer.

Enrollment records 1

Specialty

Clinical Social Worker

Education

Other, 1992

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Telehealth

Offers telehealth services

Group practices

Community Mental Health for Central MichiganGroup PAC ID 4688660533, 44 clinicians

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

State licenses

Practice roles

Locations

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

• Community Mental Health for Central Michigan

  • Psychiatry Physician
  • Mt Pleasant, MI
  • NPI 1881622892

  Clinical, MI

  Medicare reassignment Care Compare group NPD

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1560729600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1560729600000",
    "number": "1194385633",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "612 CORVUS DR",
            "city": "MIDLAND",
            "state": "MI",
            "postal_code": "486428111"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "612 CORVUS DR",
            "city": "MIDLAND",
            "state": "MI",
            "postal_code": "486428111",
            "telephone_number": "614-805-2930"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WIESE",
        "first_name": "KELLEY",
        "middle_name": "SUSAN",
        "credential": "MSW",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2019-06-17",
        "last_updated": "2019-06-17",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "MI",
            "license": "6801103963",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Jennifer J. Whyte, MSW
• Megan Whyte, LMSW
• Hannah Leigh Wicks, MS, OTR
• Geri Ann Wieland, PA-C
• Collin Wierda, PHARMD
• Felice Wilford
• Catherine A Wilk, MSW, LCSW
• Carrie Wilke
• Yvonne M Will-Murphy, D.O. PH.D.
• Sarah Willard, RN, IBCLC

• Clinical Social Worker in Midland, MI
• Providers in Midland, MI by specialty
• Clinical Social Worker in Michigan

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 17, 2019; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.